title: Catastrophic transcatheter baffle fenestration for failing Fontan physiology.
abstract: Transcatheter fenestration and balloon dilation of an atrial baffle created from native atrial tissue was attempted in a 15-year-old girl with failing Fontan physiology and protein-losing enteropathy. After transseptal puncture, initial dilations with a 10-mm and 12-mm diameter balloon resulted in an inadequate fenestration, with no significant decrease of right atrial pressure or systemic arterial saturation. Dilation of the fenestration with a 16-mm-diameter balloon produced a tear of the atrial septum and subsequent death. Balloon dilation of native atrial tissue may result in uncontrolled tears of the atrial septum.
authors.affiliation: Department of Cardiology, Wilhelmina Children's Hospital, Utrecht, The Netherlands.
authors.forename: H T
authors.initials: HT
authors.lastname: Henneveld
authors.forename: P
authors.initials: P
authors.lastname: Hutter
authors.forename: F J
authors.initials: FJ
authors.lastname: Hitchcock
authors.forename: N
authors.initials: N
authors.lastname: Sreeram
mesh_terms: D000015:Abnormalities, Multiple; D000293:Adolescent; D006328:Cardiac Catheterization; D002404:Catheterization; D017809:Fatal Outcome; D005260:Female; D018729:Fontan Procedure; D006325:Heart Atria / Q000601:surgery*; D006801:Humans; D011183:Postoperative Complications; D011504:Protein-Losing Enteropathies / Q000628:therapy*; D012086:Reoperation; D016896:Treatment Outcome